Robot-assisted laparoscopic radical prostatectomy

The advantage of minimally invasive surgery in the form of laproscopic radical prostatectomy compared with open retropubic radical prostatectomy is indisputable. But a long learning curve seems to be a clear disadvantage. Robotic surgery devices such as the da Vinci system could be very helpful here. The aim of this study was to demonstrate our own experience with da Vinci prostatectomy in consideration of the learning curve. Since implementation of the da Vinci system 23 months ago, we have done over 300 operating procedures with the system. Despite of having great know how in laparoscopic surgery the conversion rate was only 1.7%. The oncological outcome was satisfactory and comparable with the results reported in the literature. A complication rate of only 5.1% also seems acceptable. With the da Vinci system, we can combine the advantages of a minimally invasive procedure with those of open surgery but without the disadvantage of a long learning curve. At the moment, the expense factor remains a handicap.